Building a great team is challenging, but the rewards are worth the effort. This article shares nine tips for success based on my experience.


Early in my career, I hired people based on their skills, results, and experience. For example, when seeking an optometric technician, I looked for experience in a medical, optometry, or ophthalmology practice. I soon realized, however, that this approach did not guarantee a great team.

I now emphasize attitude, cognition, and habits. Does a candidate work well with people? Is he or she eager to learn? Does he or she have an excellent work ethic? Is he or she open to feedback? I can teach technician skills, but not personality. Soft skills are vitally important!


This change in hiring emphasis requires more training time—something that can be hard to come by at a busy, understaffed practice. It can be tempting to hire the first person who comes along. It could costs three times a staff member’s salary (or more) to replace him or her. In other words, be patient and take your time. Moreover, don’t stop looking for new team members once a job opening is filled. Keep an eye out for excellent recruits.


People are inclined to hire individuals they like and who are like them, but this can lead to an imbalance. Highly successful teams include members with various personalities who complement each other. Use personality testing to uncover how candidates are wired and how their emotional intelligence fits with the duties of the positions they will fill, the rest of the team, and your practice culture (Table).


Try to disqualify as many applicants as possible. One way is to break the interview process into several steps. For example, you could require a telephone interview followed by an in-person interview and then a group interview with other team members. I have found two advantages to this strategy.

First, it can reveal things about candidates I might not otherwise discover during the interview process. There are five or six steps in my job application process. If a candidate cannot follow simple instructions, I don’t waste my time interviewing him or her.

Second, it involves my existing team members in the process. This creates buy-in from my team, allows them to contribute valuable insights, and sets the new employee up for better onboarding success.


New team members require guidance to succeed. Create a clear onboarding process. What do you expect from new staff members on their first day on the job and by 1 week, 1 month, 3 months, 6 months, and 1 year after they start? What should they expect from you?

Develop your team. Give feedback regularly, not just once or twice per year. According to Fred Luthans, an expert on organizational behavior,1 performance feedback has the greatest effect when:

  • Feedback is solicited with positive affect, meaning that the person you are giving feedback to is receptive to hearing it. Is he or she open to development and performance management? Did you do a good job of setting up the conversation?
  • Feedback is delivered immediately after a behavior is observed.
  • Feedback can be represented through a measurable outcome. It’s difficult to argue with data. This helps separate fact from fiction.
  • Feedback is specific to the behavior targeted for change.

Ask for permission before giving feedback, and make sure your comments are specific. “Well done” is not good enough.

Don’t forget to ask your team for feedback on how you are doing as well. A simple ask goes a long way. I do this in my one-on-one conversations with my team to find out what I can do to empower them. How can I better support them in what they are working on? If it’s a new concept, I ask if I explained it clearly enough and whether I can do anything else to help them. If it’s a new process we are implementing, I ask if I could have done anything better to help our outcome. I find these two-sided conversations to be incredibly powerful, as they increase our productivity.


Invest in training and continuing education for your team. What if you train and invest in employees and then they leave? If you have ever asked or wanted to ask that question, I would counter with this one: What happens if you don’t train them, and they stay?


Don’t micromanage your staff. Be clear about their responsibilities and the outcomes you want them to achieve. Hold them accountable in terms of progress and results but give them the freedom to reach goals their way.

Encourage them to develop plans for how to handle barriers and setbacks. Research on implementation intentions by psychologist Peter Gollwitzer can be helpful here. Implementation intentions are designed to help individuals know when, where, and how they will reach goals.2 For example, if your goal is to drink six glasses of water a day, your implementation intentions may be as follows:

  • If the hand on the clock is at an even number, I will drink a glass of water.
  • If I miss an even-numbered hour, I will drink a glass of water when the hand of the clock is on the next odd-numbered hour.
  • I will keep a bottle of water with me at all times.
  • If it is an odd-numbered hour and my water bottle is less than half full, I will refill my bottle.


How ideas are communicated matters. During structured meetings, use the phrase “yes and” instead of “no but.” The former is taught in improvisational comedy classes, but I find it can also effectively push conversations in medical practices forward.

Encourage your staff to collaborate on solving problems. Also teach your team that conflict does not have to be bad; it can propel an organization forward. Use role playing to enable them to navigate conflict and teach your staff how to have tough conversations.3


I have been guilty of spending time trying to make an incompetent staff member a mediocre one while leaving competent staff members to operate on cruise control. It is a common mistake. Your energy, resources, and time are better spent helping a competent employee become a star performer. Truly incompetent members have to be released to their destiny. (Truly incompetent meaning that there is no seat in your organization where this individual can become competent.) Your stars want to work with other stars.


As Halford E. Luccock said, “No one can whistle a symphony. It takes a whole orchestra to play it.” The most talented person cannot move an organization forward alone. Surround yourself with team members who will help you achieve your practice goals and invest in your employees. Their success is yours.

  • 1. Luthans F. Organizational behavior: an evidence-based approach, 12th ed. New York, NY: McGraw-Hill Irwin; 2011.
  • 2. Gollwitzer PM. Implementation intentions: strong effects of simple plans. American Psychologist. 1999;54:493-503.
  • 3. Brown B. Dare to lead: brave work, tough conversations, whole hearts. New York: Random House; 2018.